Royal Family KIDS Anchorage: Camper Application 2025

Royal Family KIDS Anchorage

For Children 7-11 years old

who are currently within the foster care system

Camp Dates: July 14 - 18, 2025

Camper Application

Questions: royalfamily@communitycovenant.net
Camper Registration Form - any application not fully completed will be returned and the child will be at risk of not being accepted to camp. Priority is given to children currently in foster care vs adopted/guardianship.
Child's Name*

First NameLast Name
Preferred Name*
Please upload a current photo of child (headshot).

Upload a File

Cancelof
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*

MaleFemale
Birth Date*

MonthDayYear
Age*
Emotional Age*
School*
Grade*
Reading Level*
This child is currently:*

in foster carelegally freeadoptedlegal guardianshipwith biological parent(s)
Is this child from one or more of the races from the following list? (Please note this information does not determine acceptance status. It is used only for statistical reporting)*

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or other Pacific IslanderWhitePrefer to not discloseHispanic or LatinoOther
Is this child Alaska Native? (Please note this information does not determine acceptance status. It is used only for statistical reporting)*

YesNoPrefer to not disclose
Moved in foster placements, how many times?*
This child is living with*

foster parent(s)group homeadoptive parentlegal guardianrelative (ie grandmother, cousin)biological parent(s)
Name(s) of person(s) the child is living with from above:
Primary Phone of Caregiver*

Area CodePhone Number
Secondary Phone*

Area CodePhone Number
E-mail*
Alternate Contact (not the OCS Protective Services Specialist. Someone not living in your home).*
Phone*

Area CodePhone Number
Alternate Contact's relationship to Child*
OCS Protective Services Specialist (*please use accurate spelling*).*
Day Phone

Area CodePhone Number
OCS Protective Services Specialist Email (*please use accurate spelling*)
Explain any unusual family circumstances that make camp especially important for the child: (ex recent crisis, being moved in foster placement, severe economic needs, etc.)*
Camper's Emotional/Behavioral History
Check all that apply*

AggressivenessBedwettingBitingEating DisordersHyperactiveTantrumsLyingNight TerrorsNightmaresRuns AwaySexual Acting OutStealsCruelty to AnimalsNo behaviors listed above apply
Other
If any items above checked, please provide suggestions of effective ways to prevent or resolve behavior.
Suggestions of effective ways to reinforce positive behavior.
Campers Details
Camper T-Shirt Size*

Child MediumChild LargeAdult MediumAdult LargeAdult XLarge
Has this camper participated in previous Royal Family KIDS Camps?*

YesNo
If yes, what year and location
Names of other children in your home who have applied for RFK 2025*
Camper's Health History - indicate all known allergies, illness, disabilities, physical limitations, or medical complications
Allergies and Reactions*
Illnesses/medical complications
Disabilities/ Limitations
Check all that apply:

Respiratory ProblemsHypoglycemiaBone or Joint problem or fracturesHeart or circulationDizzy spellsAsthmaSeizure DisordersHay FeverAnaphylactic ShockBalance ProblemsDiabetesFaintingInsect BitesAllergies
Details from above
Please include anything that our on site nursing staff should know about this child:*
Any specific activities to be restricted?
Immunizations current*

YesNo
Prescription Medication - all medication sent to camp must be in original container with the pharmacy label on it.
Is your child taking any medications?*

YesNo
1. Medication
Dosage
How Given
Times to Give
2. Medication
Dosage
How Given
Times to Give
3. Medication
Dosage
How Given
Times to Give
4. Medication
Dosage
How Given
Times to Give
Health Care Provider Name*
Phone Number*

Area CodePhone Number
I understand that it is my responsibility as caregiver to make sure that all instructions are clear and that the necessary dosage is adequately supplied for the duration of camp. I hereby authorize the Royal Family KIDS Anchorage camp nurses to administer the above medication from July 15-19, 2024. Medications must come in the original prescription bottle with the correct dosing on the label. Be prepared to review the medications and prescriptions with the camp nurses.
Child's Medicaid # / Child's Denali Kid Care #*
Permission to administer over-the counter medications

I hereby authorize the Royal Family KIDS Anchorage camp nurses permission to administer the following products according to manufacturer's instructions, or as otherwise specified. I trust the camp nurses to use their professional judgement as situations arise, and if in doubt contact the person listed below for verification.
Contact Name*
Phone Number*

Area CodePhone Number
Please check for the medications listed below to NOT be administered by Royal Family KIDS Anchorage camp nurses:
Sun BlockTylenolBand AidsCough DropsAntacidInsect RepellentIbuprofenAnti-itch CreamDecongestantPepto BismalRash OintmentAntiseptic OintmentCough SyrupAntihistamineMy child can receive any and all of these OTC medications.
Other
Other
Detailed Instructions regarding above list, if any
Name of Individual Completing Application*

First NameLast Name
Relationship to Camper*

OCSFoster FamilyFamily MemberOther
Parent or Legal Guardian Signature (Sign with finger on mouse pad or with your mouse)*
Please note if child is in foster care, a form will be sent to the listed OCS Protective Specialist for their signature to ensure they are aware of the Child's involvement in Royal Family KIDS Anchorage.
Hosted by: Rabbit Creek Church 3401 Rabbit Creek Road, Anchorage 99516
Should be Empty:

Camper Registration Form - any application not fully completed will be returned and the child will be at risk of not being accepted to camp. Priority is given to children currently in foster care vs adopted/guardianship.

Camper's Emotional/Behavioral History

Campers Details

Camper's Health History - indicate all known allergies, illness, disabilities, physical limitations, or medical complications

Prescription Medication - all medication sent to camp must be in original container with the pharmacy label on it.

Permission to administer over-the counter medications

Hosted by: Rabbit Creek Church 3401 Rabbit Creek Road, Anchorage 99516